Individual
MS. ANDREA M WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
772 SMILEY AVE, CINCINNATI, OH 45240-1948
(513) 562-7443
Mailing address
772 SMILEY AVE, CINCINNATI, OH 45240-1948
(513) 562-7443
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN113192
OH
Other
Enumeration date
05/19/2010
Last updated
05/19/2010
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